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Area of Science:

  • Ophthalmology
  • Medical Imaging
  • Artificial Intelligence

Background:

  • Posterior uveal melanoma (UM) is a rare but serious ocular malignancy.
  • Accurate differentiation between UM and benign nevi is crucial for appropriate patient management.
  • Existing diagnostic methods can be limited, necessitating advanced analytical tools.

Purpose of the Study:

  • To evaluate the performance of RETFound, a self-supervised deep learning model, in distinguishing between uveal melanoma and nevi.
  • To assess the model's utility in classifying healthy eyes alongside UM and nevi.
  • To validate the model's accuracy on a large, single-center dataset.

Main Methods:

  • A case-control study utilizing ultrawidefield fundoscopy images (color and autofluorescence) from 4255 patients.
  • Analysis of 18,510 UM, 8,671 nevi, and 1,192 healthy eye images after quality exclusion.
  • Fine-tuning the RETFound deep learning model for binary (UM vs. nevi) and tertiary (UM vs. nevi vs. healthy) classification tasks.

Main Results:

  • The model achieved an AUROC of 0.90 and accuracy of 0.83 for binary classification (UM vs. nevi).
  • For tertiary classification, the model demonstrated a mean accuracy of 0.82 and an AUROC of 0.92.
  • These results indicate strong performance in differentiating ocular pathologies.

Conclusions:

  • Self-supervised deep learning models like RETFound are feasible for accurate differentiation of UM and nevi.
  • The model shows high accuracy in a large, imbalanced dataset from a single clinical center.
  • Further validation on external cohorts is planned to assess broader clinical applicability.